64 slice CAT scan

[dpasse]

I am 48 years old. On november 2009 I consulted a Cardiologist for sporadic chest pains during my triathlon training. On examination the ecg was ok but for safety and since I had a race coming up he ordered a SPECT. The result was normal and he said I could continue my life normally. Since then I continued my training and competed in two events, but since the pains continued to appear sporadically, I visited again the doctor, and he ordered an eco stress which I did with effort up to 190 bpm (110% max heart freq), and the result was completely normal. He said that given the results, he reccommended no further test from the heart disease point of view. I insisted that the problem was affecting my life since I am abandoning my sports activity for fear of suffering a serious condition. He told me the next step would be a cardiac cathetherism but he could not reccommend it given the present results, since for me the risks would be greater than the benefits of such a study. I consulted another Doctor and he said I could get a study called a 64 slice CAT, which was less traumatic than a catheterism. On consulting my cardiologist againg, he told me that this study involved an important dose of radiation, and that it has relatively high incidence of cancer induction (>1%), which is the reason why, if he had considered necessary he would go with the cathetherism. Despite his opinion,I have an appointment for the heart CAT scan, but I would like to know another professional opinion on this last issue (radiation and cancer risks involved). Thank you.

[Cleveland Clinic]

The risk of cancer is very low, certainly less than 1%.  However, I personally don't think you should have the test done.  This isn't because of the risk of radiation, but because your risk of hemodynamically significant CAD is very low given the other normal stress tests.  

[Cleveland Clinic]

There is about a 1% risk of a serious complication including death.  Most cardiologist won't do these unindicated tests just to reduce one's anxiety level because of this risk.  I definitely support their opinion.  

[dpasse]

Thank you very much. That is the same argument the cardiologist is giving me. But he said if I kept insisting and the medical insurance approved he could order a cathetherism. Is there significant risk involved in this study, that would make not worth taking? I am an hypochondriac and fear has completely paralized my sport activity. Thanks for the advice and the patience..